Skill-Based Electronic Gaming Machines: Features that Mimic Video Gaming, Features that could Contribute to Harm, and Their Potential Attraction to Different Groups.

New gambling products have been developed over time as technology permits. For example, early mechanical slot machines were later replaced by electronic gaming machines (EGMs), which enabled a faster speed of play and more immersive experience. EGMs have in the decades since their invention become one of the main drivers of gambling expenditure worldwide and are one of the gambling products most strongly associated with harm. This literature review considers research relevant to a new subcategory of EGM, 'skill-based' EGMs, termed 'SGMs' here. SGMs can be highly varied in content, with some representing a minimal departure from EGMs, where the typical bonus round is replaced by some skill-based activity, such as a simple video game, which could increase the machine's appeal. Other SGMs feature more radical departures from conventional EGMs, such as multiplayer games using intellectual property from popular TV shows or video games. These skill-based elements could tap into common gambling fallacies such as the illusion of control, and therefore facilitate harmful engagement. SGMs could also be less harmful than current EGMs, if skill-based elements break the dissociative states associated with EGM gambling. The intellectual property used in SGMs may increase their appeal among people who generally do not gamble, and the skill-based elements could increase their interest among gamblers who predominately prefer skill-based gambling formats such as sports betting. The novelty and varied content of SGMs present many open questions, which research should aim to address in future.

Childhood Use of Coin Pusher and Crane Grab Machines, and Adult Gambling: Robustness to Subjective Confidence in a Young Adult USA Sample.

Gambling as a youth is a risk factor for experiencing gambling-related harm as an adult. Most youth gambling research focuses on illegal engagement with age-restricted products, but youth can also gamble legally, by for example betting with friends, or via coin pusher and crane grab machines. Research has associated recollected rates of usage of these machines as a child with adult gambling participation and problems, but only in the UK and Australia, and has not tested for robustness to subjective confidence. The present study conceptually replicated these prior studies by investigating the association between recollected childhood use of coin push and crane grab machines, and adult gambling behavior, in a young adult USA sample. Participants rated their subjective confidence to test if individual differences in recollection biases provided a better account for any observed associations. Results found high recollected engagement rates for both coin pusher (87.2%) and crane grab machines (97.0%), and 5 of the 6 tested associations between youth machine usage and adult gambling engagement and problems were significant and in the hypothesized direction. Rates of subjective confidence were on average high (83.3 and 89.2 on a 0 to 100 scale), and generally did not interact with participants' recollected rates of machine use. These findings extend prior research on potential public health concerns around children's legal engagement with coin pusher and crane grab machines to a new country, the USA.

Opening Pandora's Loot Box: Weak Links Between Gambling and Loot Box Expenditure in China, and Player Opinions on Probability Disclosures and Pity-Timers.

Loot boxes are quasi-gambling virtual products in video games that provide randomised rewards of varying value. Previous studies in Western contexts have identified a positive correlation between loot box purchasing and problem gambling severity. A preregistered survey of People's Republic of China (PRC) video game players (N = 879) failed to replicate this correlation. We observed statistically significant but weak positive correlations between loot box expenditure and past-year gambling participation, and between loot box expenditure and impulsiveness. This study cannot prove that loot boxes are not disproportionately purchased by people with problem gambling symptomatology in the PRC or that PRC players are not potentially at risk of loot box-related harms. Instead, the evidence suggests that the relationship between loot boxes and gambling might be weaker in the PRC than in Western countries. We identified multiple unique factors about the PRC that might be affecting this relationship. For example, the lotteries are the only legally permitted form of gambling. More gamified electronic gambling products are unavailable. The limited availability of gambling meant that a low level of gambling participation (n = 87) was observed, which is a limitation of this study. Additionally, the PRC is presently the only country to legally require loot box probability disclosures as a consumer protection measure. Most loot box purchasers (84.6%) reported seeing loot box probability disclosures, but only 19.3% of this group reported consequently spending less money. Most loot box purchasers (86.9%) thought that pity-timers, which increase the winning probabilities of obtaining rarer rewards, are appropriate for implementation. Future loot box research should give greater consideration to differing cultural contexts and novel consumer protection measures.

Designing Improved Safer Gambling Messages for Race and Sports Betting: What can be Learned from Other Gambling Formats and the Broader Public Health Literature?

Safer gambling messages are one potential input to a public health approach toward reducing gambling-related harm, and yet there is no strong evidence supporting current messages such as "gamble responsibly" or "keep the fun in the game". Furthermore, sports betting is increasing in popularity in multiple jurisdictions, such as Australia and the US, increasing the need to design effective messaging campaigns for race and sports betting. Compared to other gambling formats, such as electronic gambling machines, the level of potential skill involved in race and sports betting may raise unique issues regarding the design of effective messages. This review first highlights research from the related public health domains of alcohol and tobacco. Then, five potential areas for further messaging-based research in race and sports betting are discussed: teaching safer gambling practices, correcting gambling misperceptions, boosting conscious decision making, norm-based messages, and emotional messages. A broad approach to message design is encouraged, given the potential for individual differences in message receptivity, and for frequently-repeated messages to be ignored or cause negative psychological reactance.

A framework for indirect elicitation of the public health impact of gambling problems.

Gambling problems are increasingly understood as a health-related condition, with harms from excessive time and money expenditure contributing to significant population morbidity. In many countries, the prevalence of gambling problems is known with some precision. However, the true severity of gambling problems in terms of their impact on health and wellbeing is the subject of ongoing debate. We firstly review recent research that has attempted to estimate harm from gambling, including studies that estimate disability weights using direct elicitation. Limitations of prior approaches are discussed, most notably potential inflation due to non-independent comorbidity with other substance use and mental health conditions, and potential biases in the subjective attribution of morbidity to gambling. An alternative indirect elicitation approach is outlined, and a conceptual framework for its application to gambling is provided. Significant risk factors for propensity to develop gambling problems are enumerated, and relative risks for comorbidities are calculated from recent meta-analyses and reviews. Indirect elicitation provides a promising alternative framework for assessing the causal link between gambling problems and morbidity. This approach requires implementation of propensity score matching to estimate the counterfactual, and demands high quality information of risk factors and comorbid conditions, in order to estimate the unique contribution of gambling problems. Gambling harm is best understood as a decrement to health utility. However, achieving consensus on the severity of gambling problems requires triangulation of results from multiple methodologies. Indirect elicitation with propensity score matching and accounting for comorbidities would provide an important step towards full integration of gambling within a public health paradigm.

Exposure to Gambling and Alcohol Marketing in Soccer Matchday Programmes.

The UK's Premier League and Championship are two of the most well attended soccer leagues worldwide; however, little is known regarding exposure to gambling marketing through the matchday experience. The current study sought to quantify exposure to gambling and alcohol marketing, and responsible gambling messages within matchday programmes. Programmes for each team in the English Premier League and Championship were analysed across consecutive matchday weekends, made available to 1,269,404 match-going fans. Direct adverts for, and incidental exposure to, gambling, alcohol, and responsible gambling marketing or messages were coded. Direct adverts were counted, as were absolute counts and percentage of pages with incidental exposure. Programmes averaged 2.3 direct gambling adverts and 37.8 instances of incidental gambling marketing exposure. Incidental gambling marketing was found on 22.2% of pages. There was more gambling marketing than either alcohol marketing or responsible gambling messages. This was observed across: number of direct adverts (p < .001), incidents of exposure (p < .001) and the percentage of pages with exposure (p < .001). Teams with gambling shirt sponsors had more incidental marketing exposure, in both absolute count (p < .001) and percentage of pages (p < .001) but did not have more direct gambling adverts (p = .63). Incidental exposure to gambling marketing was present in 59.0% of children's specific sections of programmes. There was greater exposure to gambling marketing in soccer matchday programmes. Gambling marketing was frequently evident in child specific sections of matchday programmes. Attending soccer matches and reading the matchday programme increases exposure to gambling.

The relationship between gambling behaviour and gambling-related harm: A data fusion approach using open banking data.

BACKGROUND AND AIMS: UK-based gambling policymakers have proposed affordability checks starting at monthly losses of £125. The present study combines open banking data with self-reports of the Problem Gambling Severity Index (PGSI) and other relevant information to explore the harm profiles of people who gamble at different levels of electronic gambling behaviour. DESIGN, SETTING AND PARTICIPANTS: This was a data fusion study in which participants consented to share their bank data via an open banking application programming interface (API) and who also completed relevant self-report items. Hierarchical hurdle models were used to predict being an at-risk gambler (PGSI > 0) and being a 'higher-risk' gambler (higher PGSI scores among those with non-zero scores) using four specifications of electronic gambling behaviour (net-spend, outgoing expenditure, incoming withdrawals, interaction model combining expenditure and withdrawals), and by adding self-reported data across two additional steps. The study took place in the United Kingdom. Participants were past-year people who gamble (n = 424), recruited via Prolific. MEASUREMENTS: Self-report measures were used of gambling-related harm (PGSI), depression [Patient Health Questionnaire 9 (PHQ-9)], age and gender; bank-recorded measures of income and electronic gambling behaviour. FINDINGS: Unharmed gamblers had an average monthly gambling net-spend of £16.41, compared with £208.91 among highest-risk gamblers (PGSI ≥ 5). Being an at-risk gambler (PGSI > 0) was predicted significantly by all four types of gambling behaviour throughout all three steps [1.08 ≤ odds ratios (ORs) ≤ 2.92; Ps < 0.001), with only outgoing expenditure being significant in the interaction model (2.26 ≤ ORs ≤ 2.81; Ps < 0.001). Higher PHQ-9 scores also predicted at-risk gambling in steps 2-3 (1.09 ≤ ORs ≤ 1.10; Ps < 0.001), as did lower age (0.95 ≤ ORs ≤ 0.96; Ps < 0.001) and male gender identity in step 3 (2.51 ≤ ORs ≤ 2.95; Ps < 0.001). Being a higher-risk gambler was predicted significantly by gambling behaviour only in the expenditure-only (1.16 ≤ ORs ≤ 1.17; Ps ≤ 0.048) and withdrawal-only (1.08 ≤ ORs ≤ 1.09; Ps ≤ 0.004) models, and was not predicted by income (0.98 ≤ ORs ≤ 1.14; Ps ≥ 0.601), age (0.98 ≤ ORs ≤ 0.99; Ps ≥ 0.143) or male gender identity (1.07 ≤ ORs ≤ 1.15; Ps ≥ 0.472). CONCLUSION: The UK government's proposed affordability checks for gamblers should rarely affect people who are not experiencing gambling-related harm. At-risk gambling is predicted well by different types of gambling behaviour. Novel insights about gambling can be generated by fusing self-reported and objective data.

Beyond 'single customer view': Player tracking's potential role in understanding and reducing gambling-related harm.

BACKGROUND: Usage of electronic gaming machines (EGMs) and on-line gambling is strongly associated with gambling-related harm. Player-tracking systems can monitor a gambler's activity across multiple sessions and/or operators, providing a clearer picture of the person's risk of harm with respect to these gambling formats and enabling harm reduction efforts. The Finnish and Norwegian state monopolies have player-tracking systems in place, while the United Kingdom is implementing an operator-led system called 'single customer view' for on-line gambling, and Australian states are proposing similar 'player cards' for land-based EGMs. ARGUMENT: Player tracking can advance harm reduction efforts in three ways. First, player tracking improves our understanding of gambling-related harm by providing data on how the population gambles, which can potentially be linked with operator, government and/or prevalence data sets. Secondly, player tracking can be used to implement harm reduction measures such as expenditure limits, self-exclusion and age verification. Thirdly, player tracking can provide a platform to evaluate harm reduction measures via gold-standard field trials. These potential benefits need to be weighed against various practical and ethical issues. CONCLUSIONS: The potential benefits of player-tracking systems would be maximized via systems administered independently of the gambling industry and implemented universally across all gambling in a given jurisdiction.

Feature preferences of sports betting platforms: A discrete choice experiment shows why young bettors prefer smartphones.

Background and aims: Smartphone, computer and land-based betting platforms each have distinctive features. This study examined 1) preferred features of sports betting platforms amongst young adults and 2) whether feature preferences vary with gambling severity. Methods: The study surveyed 616 Australians aged 18-29 years who bet at-least monthly on sports, esports and/or daily fantasy sports. Participants provided a simple rating of the importance of 24 features of betting platforms and then completed a discrete choice experiment to indicate their preferences amongst different groups of features. Results: Smartphones were the only platform providing all preferred features. The most important feature was ability to bet instantly 24/7 from any location, followed by electronic financial transactions. Less important features were ability to access betting information online and to bet with multiple operators. Social and privacy features, and access to promotions, did not significantly predict platform choice. The experiment found no significant differences in preferred features by gambling severity group or by gender. The non-experimental descriptive data, however, indicated that participants in the moderate risk/problem gambling categories placed significantly more importance on privacy, ability to place in-play bets, bet with cash, bet with a credit card, see frequent promotions, and bet with multiple operators. Discussion and conclusions: Most features that bettors prefer can intensify betting. Curtailment of betting promotions, in-play betting, and credit card betting are measures that can assist higher-risk gamblers without unduly affecting other gamblers. Consumer protection tools, including mandatory pre-commitment, need strengthening to help counter the unique risks of smartphone betting.

The COVID-19 lockdown experience suggests that restricting the supply of gambling can reduce gambling problems: An Australian prospective study.

Background and aims: COVID-19 lockdowns limited access to gambling but simultaneously elevated psychosocial stressors. This study assessed the relative effects of these changes on gambling risk status during and after the Australian COVID-19 lockdown from late-March to late-May 2020. Methods: The study administered three surveys to people who had gambled within the past year at T1. Wave 1 asked about before (T1, N = 2,125) and during lockdown (T2, N = 2,125). Subsequent surveys focused on one year (T3; N = 649) and two years after lockdown (T4, N = 458). The dependent variable was changes in reporting any problem gambling symptoms (PGSI 0 vs 1+). Bivariate analyses and multinomial logistic regression tested for significant associations with: demographics, psychosocial stressors (perceived stress, psychological distress, loneliness, health anxiety about COVID, financial hardship, stressful life events), gambling participation and gambling frequency. Results: Gambling participation and at-risk gambling decreased between T1 and T2, increased at T3, with little further change at T4. When gambling availability was curtailed, decreased gambling frequency on EGMs, casino games, sports betting or race betting, and lower psychosocial stress, were associated with transitions from at-risk to non-problem gambling. When gambling availability resumed, increased EGM gambling frequency, decreased online gambling frequency, and higher psychosocial stress were associated with transitions from non-problem to at-risk gambling. Discussion and conclusions: Gambling availability appears a stronger influence on gambling problems, at the population level, than psychosocial risk factors. Reducing the supply of high-risk gambling products, particularly EGMs, is likely to reduce gambling harm.

Evaluation of real-world preferences and performance of hearing aids fitted according to the NAL-NL1 and DSL v5 procedures in children with moderately severe to profound hearing loss.

OBJECTIVE: The study aims to compare the performance of hearing aids fitted according to the NAL-NL1 and DSL v5 prescriptive procedure for children. DESIGN: This is a crossover four period trial. STUDY SAMPLE: Sixteen school-aged children with moderately severe to profound hearing losses participated in the study. The children were fitted with Phonak Naida V SP hearing aids according to the two prescriptive procedures. RESULTS: The results showed that children performed significantly better with DSL v5 than with NAL-NL1 prescription for sentence perception in quiet. The paired-comparison judgments of speech intelligibility showed seven children significantly preferred the DSL v5 prescription while two children preferred the NAL-NL1 prescription. The average scores on functional and ratings by parents and teachers performance of children in real life were significantly better for the DSL v5 prescription. At the end of all trials, nine children preferred the DSL v5 prescription, four preferred the NAL-NL1 prescription, and two had no preference. CONCLUSIONS: Hearing aids fitted based on the DSL v5 procedure would seem to be more appropriate than the NAL-NL1 procedure for children with moderately severe to profound sensorineural hearing loss, at least in quiet listening environments.

Associations between recollected rates of Category D fruit machine use as a child and adult gambling in a young adult sample.

There have been recent restrictions to the range of gambling products made available to UK children, with the industry association Bacta introducing a minimum age of 18 for Category D fruit machines, which can otherwise be legally used by children. Any potential government action on Category D fruit machines may want to consider limitations in the current evidence base. The present study addressed this issue, by conceptually replicating previous results associating recollected usage of Category D fruit machine usage as a child and adult gambling. Compared to previous studies, the present study used a younger adult sample, and also tested for potential moderation by subjective confidence. Three out of four main tested associations were significant and in the hypothesised direction, and a lack of significance on interaction terms yielded no evidence of potential moderation by subjective confidence. The present study therefore added to the limited evidence base on potential risks of legal Category D fruit machine usage as a child.

Childhood use of coin pusher and crane grab machines, and adult gambling: A conceptual replication of Newall et al. (2021).

Background and aims: Youth gambling research mainly focuses on the illegal use of age-restricted machines, but coin pusher and crane grab machines are gambling machines that can be used by people of any age in the UK, and are also in use internationally. Previous cross-sectional evidence has associated recollected childhood usage of these machines with adult gambling participation and levels of problem gambling amongst adult gamblers. We attempted to conceptually replicate the findings of one of these studies (Newall et al., 2021), while addressing some limitations of that study. Methods: A cross-sectional survey of 2,000 UK-based and -born participants aged 19-24 years. The measures were participants' recollected usage of coin pusher and crane grab machines as a child, whether they had gambled in the past 12-months or not, and the PGSI for past 12-month gamblers. Results: Overall, 5 of 7 tested associations were significant and in the hypothesized direction. Logistic regression models showed that adult gamblers were more likely to recollect using, and used at higher levels of frequency, coin pusher and crane grab machines, than non-gamblers. Then, negative binomial regression analysis showed that adults who recollected using crane grab machines at higher levels of frequency showed more gambling-related problems. Discussion and Conclusions: These results suggest that childhood usage of coin pusher and crane grab machines may act as an underappreciated risk factor for the development of gambling-related harm across the lifespan. This information may be considered for further youth gambling research and policy.

Gambling, cryptocurrency, and financial trading app marketing in English Premier League football: A frequency analysis of in-game logos.

Background & aims: The gamblification of UK football has resulted in a proliferation of in-game marketing associated with gambling and gambling-like products such as cryptocurrencies and financial trading apps. The English Premier League (EPL) has in response banned gambling logos on shirt-fronts from 2026 onward. This ban does not affect other types of marketing for gambling (e.g., sleeves and pitch-side hoardings), nor gambling-like products. This study therefore aimed to assess the ban's implied overall reduction of different types of marketing exposure. Methods: We performed a frequency analysis of logos associated with gambling, cryptocurrency, and financial trading across 10 broadcasts from the 2022/23 EPL season. For each relevant logo, we coded: the marketed product, associated brand, number of individual logos, logo location, logo duration, and whether harm-reduction content was present. Results: There were 20,941 relevant logos across the 10 broadcasts, of which 13,427 (64.1%) were for gambling only, 2,236 (10.7%) were for both gambling and cryptocurrency, 2,014 (9.6%) were for cryptocurrency only, 2,068 (9.9%) were for both cryptocurrency and financial trading, and 1,196 (5.7%) were for financial trading only. There were 1,075 shirt-front gambling-associated logos, representing 6.9% of all gambling-associated logos, and 5.1% of all logos combined. Pitch-side hoardings were the most frequent marketing location (52.3%), and 3.4% of logos contained harm-reduction content. Discussion & Conclusions: Brand logos associated with gambling, cryptocurrency, and financial trading are common within EPL broadcasts. Approximately 1 in 20 gambling and gambling-like logos are subject to the EPL's voluntary ban on shirt-front gambling sponsorship.

Safer gambling and consumer protection failings among 40 frequently visited cryptocurrency-based online gambling operators.

OBJECTIVE: Online gambling has increased the accessibility and range of gambling products available to people all over the world. This trend has been particularly noticeable in the United Kingdom. Cryptocurrency-based gambling is a new, largely unregulated, way to gamble online, which uses mostly anonymous blockchain-based technologies, such as Bitcoin. The present research investigated consumer protection features of 40 frequently visited and U.K.-accessible cryptocurrency-based online gambling operators. METHOD: A content analysis was performed by visiting all 40 cryptocurrency-based online operators and recording their safer gambling and consumer protection practices. Coded features included aspects of the sign-up process, features of any safer gambling pages, customer support practices, and Identity verification. RESULTS: Results revealed significant failings in the account registration process; none of the operators verified the identity of new users, and 35% required only an email or no personal information for sign-up. Overall, 37.5% of operators offered no safer gambling tools and a further 20% offered only one. Additionally, 64.7% of operators continued to email promotional material after being informed of a user's impaired control when gambling. Less than half of the analyzed operators held a valid license (47.5%), and none of the operators with an available deposit page required identity verification before enabling deposits. CONCLUSIONS: These results highlight the potential risks for young and vulnerable individuals, especially when a lack of identity verification is paired with the inherent anonymity of cryptocurrencies. Furthermore, it emphasizes the need for greater policy and research attention toward cryptocurrency-based online gambling. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

What are the odds? Poor compliance with UK loot box probability disclosure industry self-regulation.

Loot boxes are purchased in video games to obtain randomised rewards of varying value and are thus psychologically akin to gambling. Disclosing the probabilities of obtaining loot box rewards may reduce overspending, in a similar vein to related disclosure approaches in gambling. Presently, this consumer protection measure has been adopted as law only in the People's Republic of China (PRC). In other countries, the videogaming industry has generally adopted this measure as self-regulation. However, self-regulation conflicts with commercial interests and might not maximally promote public welfare. The loot box prevalence rate amongst the 100 highest-grossing UK iPhone games was 77% in mid-2021. The compliance rate with probability disclosure industry self-regulation was only 64.0%, significantly lower than that of PRC legal regulation (95.6%). In addition, UK games generally made insufficiently prominent and difficult-to-access disclosures both in-game and on the game's official website. Significantly fewer UK games disclosed probabilities on their official websites (21.3%) when compared to 72.5% of PRC games. Only one of 75 UK games (1.3%) adopted the most prominent disclosure format of automatically displaying the probabilities on the in-game purchase page. Policymakers should demand more accountable forms of industry self-regulation or impose direct legal regulation to ensure consumer protection.

Peer and Parental Social Norms as Determinants of Gambling Initiation: A Prospective Study.

PURPOSE: Despite the potential consequences of gambling during adolescence, the factors involved in the initiation of this behavior are relatively understudied. Using a longitudinal design, the present study analyzed the contribution of parental and peer norms to adolescent gambling initiation. METHODS: A sample of 440 adolescent non-gamblers (50.9% males, meanage = 14.85 [standard deviation = 1.41]) completed a baseline survey and a 1-year follow-up questionnaire. The baseline survey included assessments of perceived descriptive and injunctive norms from parents and peers, perceived parent and peer gambling severity, and susceptibility to peer pressure. A multivariate hierarchical logistic regression model was used to assess the contribution of baseline measures to adolescent gambling initiation at follow-up. RESULTS: Of the 440 non-gamblers assessed at baseline, 160 (36.4%) reported initiating gambling at follow-up. All the peer factors were prospectively associated with gambling initiation, while only the perceived injunctive norms of parents were associated with initiation. Higher susceptibility to peer pressure, perceived gambling by peers, and peer and parental approval of gambling at baseline were associated with higher odds of adolescent gambling initiation at follow-up. In contrast, the likelihood of gambling initiation among adolescents decreased as the perception of peer gambling severity increased. DISCUSSION: The identification of parental and peer factors associated with adolescent gambling initiation may provide support for relevant preventative interventions aimed at avoiding or delaying gambling initiation among adolescents. Specifically, to reduce the initiation of gambling, preventative programs should focus on helping adolescents to find strategies for resisting peer influences.

Not all games are created equal: Adolescents who play and spend money on simulated gambling games show greater risk for gaming disorder.

Research reports positive associations between gaming disorder (GD) in adolescents and loot box purchasing but has not examined this relationship for other types of simulated gambling. This study examined whether greater engagement and expenditure in three types of simulated gambling were associated with meeting the criteria for GD in adolescents. A sample of Australians aged 12-17 years (N = 826) was recruited through an online panel aggregator. It included 646 gamers (57.7% male) with 89 being classified as having past-year GD, as defined and measured by the Internet Gaming Disorder Scale. Independent variables comprised past-month engagement in three simulated gambling activities (games with 'mini' gambling components, social casino games, and loot boxes), loot box purchasing, other microtransactions, impulsiveness, and demographics. Logistic regressions first examined whether engagement in each of the three simulated gambling activities was individually associated with GD, then with all three in the same model, and then controlling for demographic variables and impulsivity. Logistic regressions also examined whether microtransactions and purchasing loot boxes were individually associated with GD, then with both in the same model, and then controlling for demographic variables and impulsivity. Adolescents who had engaged in each simulated gambling activity in the past month were more likely to report meeting the criteria for GD. These relationships remained significant when controlling for common demographics and impulsiveness. Past-month engagement in social casino games increased the odds of GD 2.5 times (95% CI: 1.54; 4.02), 2.4 times for games with 'mini' gambling components (95% CI: 1.42; 3.90) and 2.0 times for engaging in loot boxes (95% CI: 1.22; 3.21), but only social casino games remained significant when controlling for engagement in all three activities. The likelihood of meeting the criteria for GD increased 3.8 times with expenditure on microtransactions (95% CI: 2.32; 6.27) and 4.6 times for buying loot boxes, and each remained significant when both were included in the model. Compared to digital games without simulated gambling elements, simulated gambling appears to attract adolescents who report GD. Implications of the results are discussed in detail.

Situational features of smartphone betting are linked to sports betting harm: An ecological momentary assessment study.

Background and aims: Smartphones extend the situational characteristics of sports betting beyond those available with land-based and computer platforms. This study examined 1) the role of situational features and betting platforms in harmful betting behaviours and short-term betting harm, and 2) whether people with more gambling problems have preferred situational features, engage more in harmful betting behaviours, and experience more severe short-term betting harm. Methods: An ecological momentary assessment analysed 1,378 betting sessions on sports, esports or daily fantasy sports, reported by 267 respondents (18-29 years; 50.9% male) over 10 weeks. Results: Factor analysis revealed five situational features of betting sessions: 1) quick, easy access from home, 2) ability to bet anywhere anytime, 3) privacy while betting, 4) greater access to promotions and betting options, and 5) ability to use electronic financial transactions. Regression models underpinned the analyses. Greater short-term betting harm was significantly associated with the ability to bet anywhere anytime, privacy when betting, and greater access to promotions and betting options. Betting sessions when these features were prioritised were more likely to involve impulsive betting, use of betting inducements, and betting with more operators. Respondents with more gambling problems were more likely to prioritise privacy and the ability to bet anywhere anytime; and to bet on in-game events, use promotional inducements, bet with more operators, and report greater betting harm. Discussion and conclusions: Certain situational features of sports betting are empirically associated with engagement and subsequent harm. Only smartphone betting combines all three features associated with betting harm.

Order of first-play in simulated versus monetary gambling.

Background and aims: Simulated gambling products, like loot boxes and social casino games, contain gambling elements, but are not classified as gambling. They are available to minors, raising concerns about a "gateway effect" into gambling. This study examined the time course of young people's engagement in simulated and monetary gambling, and associations between simulated gambling and gambling problems and harm. A necessary, although not sufficient, condition for simulated games leading to real money gambling is that simulated play must come first. Method: Participants were 1,026 young adults (aged 18-25 years) who played video games in the last year. They reported the age at which they first took part in seven simulated and twelve monetary gambling products, and current gambling problems and harm. Results: First use of loot boxes and video games with gambling content tended to precede monetary gambling. Forms where gambling is a core gameplay element, such as social casino and demonstration games, tended to follow some monetary gambling forms. Engagement in most simulated gambling products was associated with greater harm from monetary gambling. Discussion: The findings leave open the possibility of a catalyst pathway from youth engagement in loot boxes and games with gambling content to later monetary gambling, but causal psychosocial mechanisms remain unclear. However, a pathway from social casino and demonstration games to monetary gambling appears less likely, which may instead reflect containment or substitution effects. Simulated gambling disproportionately attracts youth who are vulnerable to gambling problems and harm, indicating the need for consumer protection measures.